The impact on individuals in terms of short- and long-term disability, premature death, and forgone wages will be significant. At the macroeconomic level there will be adverse impacts on labor productivity and while empirical data are scant, productivity declines and reduced economic growth may occur.
South Asian countries all face a double-disease burden. Most people in rural populations moving to urban areas will experience changes in lifestyles that may increase their NCD risks. Extreme poverty and fetal and early childhood undernutrition account for a sizable part of the total burden.
While the variation in the disease burden is large across the region, risk factors such as tobacco use are similar, suggesting that regional approaches may add value. Less is known about diet and physical inactivity but, where there are data, these are also likely issues.
Because all countries have low total expenditures on health and a substantial share of health financing comes out of pocket, all people, especially the poor, are at great financial risk, making financing a common issue in the region. Finally, unfavorable social determinants are common, such as poverty, poor education, and low social position. Addressing these determinants requires broad, multisector approaches.
Part 2 argues the case for the need to act now.
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